The Lund Report

Consumer Advocates Create Watchdog Group to Monitor CCO Development

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By sharing information and resources, they hope to make a stronger impact on CCO development

April 27, 2012—Healthcare and social justice advocates are joining together to form an ad- hoc “CCO Watchdog” group to closely monitor the implementation of coordinated care organizations throughout the state and advocate on behalf of Oregon Health Plan members.

The Oregon Center for Public Policy and Oregon Action are spearheading the effort.

Consumer Advocates Keep Careful Eye on Essential Health Benefit Workgroup

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Determining the state’s benchmark plan for an essential health benefit package is a “narrow” decision to make, but will have major ramifications for Oregon consumers

April 25, 2012—The stakes are high for choosing an insurance plan that will define Oregon’s essential health benefits package, even though the question the recent Governor-appointed essential health benefit workgroup will answer is a wonky one—especially considering that the workgroup will get into the nitty gritty details of comparing insurance plans.

Advocates Upset Over Regence's Decision to Eliminate Mental Health

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Regence's decision is bad news for Oregonians, according to Laura Etherton of OSPIRG

April 25, 2012 – Regence BlueCross BlueShield of Oregon's decision to slash mental health benefits and impose a much higher deductible for medical care and prescription coverage has consumer advocates upset. About 30,000 Oregonians who have individual policies will feel the impact starting October 1. 

Dental Care Organizations Want to Get a Jump Start on Transformation

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But Mike Shirtcliff, who thinks it’s important for dental organizations to get involved early, reports problems regarding being involved with a CCO’s formation

April 25, 2012—Although dental care organizations aren’t required to become a part of the transformation process until 2014, two groups are getting a jump start.

Mike Shirtcliff, the CEO and president of Advantage Dental, doesn’t see any reason to wait. His company, based in Redmond, provides dental care to about 187,000 people on the Oregon Health Plan, and was listed in six letters of intent sent to the Oregon Health Authority from coordinated care organizations interested in integrating mental, physical and dental healthcare for people on the Oregon Health Plan.

Regence: No Pity for Policyholders

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With the imposition of an annual deductible of at least $2,500 for those not in a group plan, this customer might have to choose between underinsurance and uninsured

OPINION -- April 25, 2012 -- Regence Blue Cross of Oregon has notified individual subscribers that beginning in October they no longer will be able to buy coverage with a deductible lower than $2,500. The new plan also slashes benefits and raises co-payments and co-insurance.

You thought the Enron guys who joked about victimizing Grandma Millie were bad? To me, Regence Blue Cross of Oregon is even worse.

Physicians Able to Bypass Insurers Under New Law

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Patients pay a monthly fee for basic health services but would still need insurance for specialized care and hospital coverage

April 25, 2012 -- In the nearly three decades as a primary care physician, Steven Butdorf has taken care of people without health insurance who’ve earned too much to qualify for government assistance. Now that the Insurance Division has issued new rules for retainer practices, Butdorf can bypass insurance companies and offer discounts to his patients. Those rules came about following passage of Senate Bill 86 in the 2011 Legislature.

Department of Corrections’ TPA May Create CCO for Prisoners and Parolees

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The organization already has experience coordinating care in Colorado

April 25, 2012— Eyebrows almost instantaneously raised during the Oregon Health Policy Board’s meeting earlier this month when board members realized that an organization serving the Department of Corrections’ inmates had submitted a letter of intent to become a coordinated care organization (CCO).

Regence Faces Legal Action from LifeWise Assurance Company

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A complaint was filed in U.S. District Court after Regence Life and Health began using the competitor’s brand name

April 18, 2012 – Regence Life and Health Insurance Company could find itself in federal court after changing its corporate name to LifeMap Assurance Company.

The for-profit company is part of Cambia Health Solutions, the parent company of Regence BlueCross BlueShield of Oregon. It sells dental, vision, disability and short-term medical insurance, and is led by William Barr, CEO.

Insurance Agents to Play Critical Role in Oregon’s Insurance Exchange

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At the same time, agents will need special training and have to meet specific criteria to become eligible

April 16, 2012--The Oregon Health Insurance Exchange wants to train and use insurance agents to help uninsured individuals and small businesses purchase insurance starting in 2014. But questions remain about the role of insurance agents and their impact on consumers who may rely on them for advice. 


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